You become may be able to access for Medicare at 65, or earlier if you have a disability or end-stage renal disease

Medicare is a federal health insurance program run by the Centers for Medicare & Medicaid Services (CMS). Most people become may be able to access at age 65, but you can also get Medicare before 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have end-stage renal disease or ALS (amyotrophic lateral sclerosis). You do not have to be retired to get Medicare — you just have to meet one of these conditions.

The process starts with contacting Social Security, not Medicare directly. Social Security handles enrollment for most people and automatically signs up those already receiving benefits. If you are not yet receiving Social Security, you will need to contact Social Security to start the process. You can do this online, by phone, or in person at a local Social Security office.

Timing matters. If you turn 65 soon, you should contact Social Security at least three months before your birthday. If you miss the important date, you may face late enrollment penalties that increase your premiums permanently. The same applies if you become may be able to access due to disability — contact Social Security as soon as you receive your disability award letter.

Key Takeaways

  • You become may be able to access for Medicare at 65, or earlier if you have been on SSDI for 24 months, have end-stage renal disease, or have ALS.
  • Contact Social Security — not Medicare — to start the process, at least three months before you turn 65 or become may be able to access.
  • If you are already receiving Social Security benefits, you will be enrolled automatically three months before your 65th birthday.
  • Medicare has four parts (A, B, C, and D), and you choose which parts you want during your initial enrollment period.
  • Missing your enrollment important date can result in permanent penalties on your premiums, so acting early is important.

How to contact Social Security to start Medicare enrollment

You have three ways to contact Social Security: online at ssa.gov, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or in person at your local Social Security office. The online option is fastest if you already have a my Social Security account. You can create one at ssa.gov and then request Medicare enrollment from your account dashboard.

When you call or visit in person, have your Social Security number, birth certificate, and proof of citizenship or legal residency ready. If you are explore before 65 due to disability, bring your disability award letter from Social Security. If you are explore due to end-stage renal disease or ALS, bring documentation from your doctor or dialysis center.

Social Security will ask you which Medicare parts you want. Part A (hospital insurance) and Part B (medical insurance) are the foundation. Part D (prescription drug coverage) is optional but recommended if you take medications. Part C (Medicare Advantage) is an alternative to Parts A and B offered by private insurers. You do not have to decide on all parts at once, but deciding during your initial enrollment period avoids penalties.

What happens if you are already receiving Social Security benefits

If you are already collecting Social Security retirement, spousal, or disability benefits, Social Security will enroll you in Medicare Parts A and B automatically three months before your 65th birthday (or three months before you become may be able to access due to disability). You do not need to do anything — the enrollment happens on its own.

You will receive a notice in the mail about 30 days before your coverage starts. This notice will tell you your Medicare number, your coverage start date, and which parts you are enrolled in. Read it carefully. If something is wrong — for example, if your name is misspelled or your date of birth is incorrect — contact Social Security right away to fix it.

Even though you are enrolled automatically in Parts A and B, you still need to choose Part D (prescription drug coverage) if you want it. You have until the end of your initial enrollment period to choose a plan. If you do not choose Part D during this window and you do not have other creditable drug coverage, you will pay a late enrollment penalty when you do join.

What to do if you are not yet receiving Social Security benefits

If you are not receiving Social Security benefits but you are turning 65 or becoming may be able to access due to disability, you must contact Social Security yourself to enroll in Medicare. Do not wait for an automatic notice — it will not come. Contact Social Security at least three months before your may be able to access date.

You can enroll online at ssa.gov if you have a my Social Security account. If you do not have an account, create one first — it takes about 10 minutes. Once logged in, look for the Medicare enrollment option. If you prefer to speak with someone, call 1-800-772-1213 or visit your local Social Security office.

When you enroll, you will choose which Medicare parts you want. If you are not sure, ask the Social Security representative to explain the difference between Original Medicare (Parts A and B) and Medicare Advantage (Part C). Both are valid options, but they work differently and have different costs. You can change your choice later during the annual enrollment period (October 15 to December 7 each year).

Understanding Medicare Parts A, B, C, and D

Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services. Most people do not pay a monthly premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Part A has a deductible and copayments for hospital stays.

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. Part B has a monthly premium (the amount changes each year based on your income) and a yearly deductible. After you meet the deductible, you typically pay 20 percent of the cost for most services.

Part C (Medicare Advantage) is an alternative to Parts A and B offered by private insurance companies. It includes all the coverage of Parts A and B, plus usually Part D (prescription drugs), and often includes dental, vision, or hearing coverage. Part C has lower out-of-pocket costs for some people but requires you to use doctors in the plan's network.

Part D covers prescription medications. It is optional, but if you do not join when you first become may be able to access and you do not have other drug coverage, you will pay a penalty for every month you delay. Part D plans vary in cost and which drugs they cover, so comparing plans during enrollment is important.

Late enrollment penalties and what they cost

If you do not enroll in Part B when you first become may be able to access, you will pay a permanent 10 percent increase to your Part B premium for every 12 months you delay. This penalty stays with you for life, even if you enroll later. For example, if you miss enrollment by two years, your premium will be 20 percent higher than it would have been.

Part D has a similar penalty. If you do not join a prescription drug plan when you first become may be able to access and you do not have other creditable drug coverage, you will pay a 1 percent increase to your Part D premium for every month you delay. Like the Part B penalty, this is permanent.

Part C (Medicare Advantage) does not have a late enrollment penalty, but you can only change plans during the annual enrollment period (October 15 to December 7). If you enroll late in Part C, you will have to wait until the next enrollment period to switch.

The only exception to these penalties is if you have creditable coverage from an employer or union while you are still working. If you have this coverage, you can delay Medicare enrollment without penalty, but you must enroll within eight months of losing that coverage.

What documents you need to have ready

Before you contact Social Security, gather these documents: your Social Security number, your birth certificate or passport, and proof of U.S. citizenship or legal residency (a driver's license, state ID, or passport works). If you are explore due to disability, bring your Social Security disability award letter. If you are explore due to end-stage renal disease, bring a letter from your nephrologist or dialysis center stating your diagnosis and treatment start date. If you are explore due to ALS, bring a letter from your neurologist.

If you are explore in person, bring originals or certified copies of these documents. If you are explore online or by phone, you may be able to upload documents or describe them to the representative. Social Security will tell you what they need.

Frequently Asked Questions

What if I turn 65 but I am still working?

You can still get Medicare at 65 even if you are working. If you have health coverage through your employer, you can keep it and delay Medicare Part B without penalty as long as your employer has 20 or more employees. When you leave your job or lose coverage, you have eight months to enroll in Part B without penalty. Contact Social Security to discuss your specific situation.

Can I get Medicare before 65?

Yes, if you have been receiving SSDI for 24 months, have end-stage renal disease, or have ALS. If you receive SSDI, Social Security will enroll you automatically in Medicare 24 months after your disability benefits start. If you have end-stage renal disease or ALS, contact Social Security as soon as you have a diagnosis letter from your doctor.

What if I miss my enrollment important date?

Contact Social Security right away. You can still enroll, but you may face late enrollment penalties on your premiums. The penalty for Part B is 10 percent per year of delay, and the penalty for Part D is 1 percent per month of delay. These penalties are permanent, so enrolling as soon as possible limits the damage.

Do I have to choose all four parts of Medicare at once?

No. You must choose Part A and Part B (or Part C as an alternative), but Part D is optional. You can enroll in Part D later, though waiting past your initial enrollment period will trigger a penalty. You can change your Part C or Part D plan every year during the annual enrollment period.

What is the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A and B) is run by the federal government and works with any doctor or hospital that accepts Medicare. Medicare Advantage (Part C) is run by private insurance companies and usually has lower out-of-pocket costs but requires you to use doctors in the plan's network. Both include hospital and doctor coverage, but they work differently and have different costs.